PSYCHODYNAMICS OF HUMAN BEHAVIOR:
Paranoid personality disorder
BIOLOGICAL OR GENETIC INFLUENCE
5 Psychological Approaches in understanding human
behavior:
1 Biological or Genetic Approach
2 Psychodynamic Approach
3 Behavioural Approach
4 Cognitive Approach
5 Humanistic Approach
Biopsychologist studies the ff:
1. All behaviour is determined by genetic, physiological
and neurological factors
2. The central nervous system and the brain is a major
Influence Normality is a properly functioning nervous
system
Major causes of abnormal behaviour
Genetic disorders
Organic (bodily) disorders
Brain disease or injury
Chemical imbalance / allergies
Mental illness
1. A genetic disorder is a disease that is caused by an
abnormality in an individual's DNA. Abnormalities can be
as small as a single-base mutation in just one gene, or
they can involve the addition or subtraction of entire
chromosomes.
Ex. Single Gene Disorders [Adenosine deaminase (ADA)
deficiency]
2. Chromosomal Abnormalities In these disorders, entire
chromosomes, or large segments of them, are missing,
duplicated, or otherwise altered.
Ex. Cri-du-Chat syndrome and Down syndrome
3. Multifactorial Disorders - These disorders involve
variations in
multiple genes, often coupled with environmental
causes.
Ex . Alzheimer's disease, Breast Ovarian Cance and
Colon Cancer
1.
2. Schizoid personality disorder
3. Schizotypal personality disorder.
Cluster B personality disorders
If someone is diagnosed with a cluster B personality
disorder, they may struggle to regulate their emotions.
Those with a cluster B personality disorder may be
described as "erratic".
1. Antisocial personality disorder
2. Borderline personality disorder
3. Histrionic personality disorder
4. Narcissistic personality disorder.
Cluster C personality disorders
Personality disorders included in cluster C are those in
which anxious and fearful behaviour is central. Individuals
with these personality disorders are often regarded as
antisocial and withdrawn. Cluster C personality
disorders include:
1. Dependent personality disorder
2. Avoidant personality disorder
3. Obsessive-compulsive personality disorder.
_______________________________________________
CLUSTER A
PERSONALITY DISORDER 1. Paranoid Personality Disorder
A personality disorder is a persistent pattern of emotions,
People with paranoid personality disorder are excessively
cognitions, and behavior that results in enduring emotional
mistrustful and suspicious of others, without any
distress for the person affected and/or for others and may
justification.
cause difficulties with work and relationships.
Symptoms:
Cluster A personality disorders
Mistrust
According to the NHS, someone with a cluster A
Violent
personality disorder may find it difficult to relate to others. Suspicious
They may show behaviour patterns that other people may Reluctant to confide in others
describe as odd or eccentric. The personality disorders I dont trust you anymore; I dont trust anyone
within cluster A include:
 Causes:
Relatives of individuals with schizophrenia may be more
likely to have paranoid personality disorder than people
who do not have a relative with schizophrenia.
Some speculation is that the roots are in their early
upbringing. Their parents may teach them to be careful
about making mistakes and may impress on them that
they are different from other people.
Cultural factors have also been implicated in paranoid
personality disorder (such as prisoners, refugees, people
with hearing impairments, and older adults, are thought
to be particularly susceptible because of their unique
experiences)
Cognitive and cultural factors may interact to produce the
suspiciousness observed in some people with paranoid
personality disorder
Treatment
Establishing a meaningful therapeutic alliance between the
client and the therapist therefore becomes an important
first step (Bender, 2005).
They often use cognitive therapy to counter the persons
mistaken assumptions about others, focusing on
changing the persons beliefs that all people are
malevolent and most people cannot be trusted (Skodol
& Gunderson, 2008).
There are no confirmed demonstrations that any form of
treatment can significantly improve the lives of people 3. Schizotypal Personality Disorder
with paranoid personality disorder
Defined by unusual and eccentric thoughts and behavior
2. Schizoid Personality Disorder
People with this Schizoid personality disorder show a
pattern of detachment from social relationships and a
limited range of emotions in interpersonal situations.
The term schizoid is relatively old, having been used by The symptoms of schizotypal personality disorder are
Bleuler (1924) to describe people who have a tendency
to turn inward and away from the outside world
Symptoms:
Cold
Social withdrawal
Avoid groups
No enjoyment
Dito lang ako
Causes of Schizoid PD
In fact, very little empirical research has been published
on the nature and causes of this disorder (Skodol et al.,
2011).
Childhood shyness is reported as a precursor to later adult
schizoid personality disorder
Causes of Schizoid PD
Reported as a precursor to later adult schizoid personality
disorder. It may be that this personality trait is inherited
and serves as an important determinant in the
development of this disorder.
Abuse and neglect in childhood are also reported among
individuals with this disorder (Johnson, Bromley, &
McGeoch, 2005).
Parents of children with autism are more likely to have
schizoid personality disorder (Constantino et al., 2009).
Treatment
Therapists often begin treatment by pointing out the value
in social relationships.
The therapist takes the part of a friend or significant other
in a technique known as role-playing and helps the
patient practice establishing and maintaining social
relationships (Skodol & Gunderson, 2008).
CLUSTER B
(psychoticism), interpersonal detachment, and
1. Antisocial personality disorder
suspiciousness. People with this disorder might have
odd beliefs or magical thinkingfor instance, the belief
that they can read other peoples minds and see into the
future.
similar to those seen in schizophrenia, but they tend to
be much milder versions of those symptoms
Symptoms:
Supernatural
Magical thinking
Poor social skills
Dirty
Causes:
Schizotypal personality disorder appears to be highly
heritable; heritability has been estimated to be about 61
percent.
Furthermore, and again paralleling findings from
schizophrenia research, people with schizotypal
personality disorder have enlarged ventricles and less
temporal lobe gray matter (Dickey, McCarley, &
Shenton, 2002).
Some people with schizotypal personality disorder have
no family history of schizophrenia. Among this
subgroup, early trauma and adversity are commonly
reported (Raine, 2006).
Treatment
Treatment includes some of the medical and psychological
treatments for depression (Cloninger & Svakic, 2009;
Mulder, Frampton, Luty, & Joyce, 2009)
Treating younger persons who have symptoms of
schizotypal personality disorder with antipsychotic
medication and cognitive behavior therapy in order to
avoid the onset of schizophrenia is proving to be a
promising prevention strategy (Correll, Hauser, Auther,
& Cornblatt, 2010; Weiser, 2011).
______________________________________________
Symptoms:
Failure to conform to social norms
 Deceitfulness
Impulsivity
Irritability and aggressiveness Treatment
Reckless disregard Schema-focused therapy. 4. Narcissistic personality disorder.
Mentalization-based therapy (MBT). Narcissistic personality disorder draws its name from the
Consistent irresponsibility
Systems training for emotional predictability and Greek mythological figure Narcissus, who fell in love
Lack of remorse with his own reflection, was consumed by his own
Prevalence: problem-solving (STEPPS).
Transference-focused psychotherapy (TFP). desire, and was transformed into a flower
Higher in males
Higher when affected by adverse sociocultural or General psychiatric management.
People with narcissistic personality disorder have a
socioeconomic factors Psychotherapy such as
grandiose view of their abilities and are preoccupied
Treatment: Dialectical behavior therapy (DBT). with fantasies of great success
Long term psychotherapy Symptoms:
Medication 3. Histrionic personality disorder Jealous
Treatment Insensitive
Sensitive to Criticism
2. Borderline personality disorder
Attention seeker
I love myself

Etiology of Narcissistic PD
Self-Psychology Mode
Social-Cognitive Mode
Symptoms
Be uncomfortable unless he or she is the center of
Treatment
attention
When therapy is attempted with these individuals, it often
Dress provocatively and/or exhibit inappropriately
focuses on their grandiosity, their hypersensitivity to
seductive or flirtatious behavior
evaluation, and their lack of empathy toward others
Shift emotions rapidly (Beck et al., 2007).
Act very dramatically, as though performing before an
Symptoms audience, with exaggerated emotions and expressions, Cognitive therapy strives to replace their fantasies with a
An intense fear of abandonment yet appears to lack sincerity focus on the day-to-day pleasurable experiences that are
A pattern of unstable intense relationships Be overly concerned with physical appearance truly attainable.
Rapid changes in self-identity and self-image Constantly seek reassurance or approval
Periods of stress-related paranoia and loss of contact with Be gullible and easily influenced by others Coping strategies such as relaxation training are used to
reality Be excessively sensitive to criticism or disapproval help them face and accept criticism.
Impulsive and risky behavior ______________________________________________
Suicidal threats or behavior or self-injury, often in Prevalence
In clinical settings, it is shown to be higher in females CLUSTER C
response to fear of separation or rejection
Wide mood swings lasting from a few hours to a few days
Treatment 1. Dependent personality disorder
Ongoing feelings of emptiness People with dependent personality disorder, however, rely
Psychotherapy
Inappropriate, intense anger on others to make ordinary decisions as well as
In practice, people with this type of illness do not
think they need treatment. important ones, which results in an unreasonable fear of
Prevalence abandonment
In clinical settings, it is shown to be higher in females
 Individuals with dependent personality disorder
sometimes agree with other people when their own
opinion differs so as not to be rejected (Bornstein, 2012) 2.4%
Symptoms:
Clinging behavior
Low self-esteem
Feels uncomfortable or helpless
Needs others to assume responsibility
Causes of Dependent PD
Genetic influences are important in the development of
this disorder (e.g., Gjerde et al., 2012)
What is not yet understood are the physiological factors
underlying this genetic influence and how they interact
with environmental influences (Sanislow et al., 2012).
Treatment
Therapy therefore progresses gradually as the patient
develops confidence in his ability to make decisions
independently (Beck et al., 2007).
2. Avoidant personality disorder
Symptoms
Avoiding work, social, or school activities for fear of
criticism or rejection. It may feel as if you are
frequently unwelcome in social situations, even when
that is not the case. This is because people with avoidant
personality disorder have a low threshold for criticism
and often imagine themselves to be inferior to others.
Low self-esteem
Self-isolation
Prevalence
Equal in both males and females.
Treatment
Avoidant personality disorder treatments vary, but they
will likely include talk therapy.
3. Obsessive-compulsive personality disorder.
Symptoms:
Obsessions
Fear of germs or contamination
Unwanted forbidden or taboo thoughts involving
sex, religion, and harm
Aggressive thoughts towards others or self
Having things symmetrical or in a perfect order
Compulsions
Excessive cleaning and/or handwashing
Ordering and arranging things in a particular,
precise way
Repeatedly checking on things, such as
repeatedly checking to see if the door is locked or
that the oven is off
Prevalence
Highest prevalent disorder ranging from 2.1-7.9%
In systematic studies, this disorder has been diagnosed as
as high on males.
Treatment
Treated either/with both medication and psychotherapy
ANXIETY DISORDERS
It changes the way that a person thinks, feels and acts.
It can seriously affect your work, personal life, and the
lives of others.
What causes Anxiety?
There are different perspectives proposed in the study
of
Its causes namely
Learning
- Conditioning by John B. Watson in his Little Albert
Experiment
Stimulus Generalization -> Reinforcement
Cognition
- Our own way of interpreting events
(Our sense of danger/threat)
Acquired Anxiety
- Through Observational Learning
Biological Perspective
- Theory of Natural Selection by Darwin in which
ancestors passed on through genetics
Genetics and Brain Chemistry
- Differs in each individual; May be irregularities in the
brain structure, chemical composition etc.
DSM IV changes into DSM V
Inclusion of selective mutism and separation anxiety
Changing Social Phobia to Social Anxiety Disorder
Removing Panic Attack as a specifier for Agoraphobia
Assigning Panic Attack as a specifier that may be applied
to a wide array of DSM-V diagnoses
Generalized Anxiety Disorder
A. Excessive anxiety and worry (apprehensive
expectation), occurring more days than not for at least 6
months, about a number of events or activities (such as
work or school performance).
B. The individual finds it difficult to control the worry.
C. The anxiety and worry are associated with three (or
more) of the following six symptoms (with at least some
symptoms having been present for more days than not for dysmorphic disorder that is characterized by the belief that Probably most people have specific fears.
the past 6 months): one's body build is too small or is insufficiently muscular. Such specific fears become a matter of concern only when
Note: Only one item required in children they are so intense as to interfere with the persons normal
Restlessness, feeling keyed up or on edge. Hoarding Disorder activities and to affect his mental health.
Being easily fatigued. This is characterized by persistent difficulty discarding or
Difficulty concentrating or mind going blank. parting with possessions, regardless of their actual value, Types of Phobia
as a result of a strong perceived need to save the items and 1. Specific Phobia
Irritability.
to distress associated with discarding them. Hoarding -> excessive, irrational fear caused by a particular object
Muscle tension. disorder differs from normal collecting. For example, or event.
Sleep disturbance (difficulty falling or staying symptoms of hoarding disorder result in the accumulation
asleep, or restless, unsatisfying sleep). of a large number of possessions that congest and clutter -> fear, anxiety or avoidance of circumscribed objects or
active living areas to the extent that their intended use is situations that is out of proportion to actual risk.
D. The anxiety, worry, or physical symptoms cause substantially compromised. The excessive acquisition
clinically significant distress or impairment in social, form of hoarding disorder, which characterizes most but Most Common Types of Phobia
occupational, or other important areas of functioning. not all individuals with hoarding disorder, consists of Acrophobia
excessive collecting, buying, or stealing of items that are Agoraphobia
E. The disturbance is not attributable to the physiological not needed or for which there is no available space. Algophobia
effects of a substance (e.g., a drug of abuse, a medication) Claustrophobia
or another medical condition (e.g., hyperthyroidism). Trichotillomania (hair-pulling disorder) Hematophobia
Characterized by recurrent pulling out of one's hair Hydrophobia
F. The disturbance is not better explained by another resulting in hair loss, and repeated attempts to decrease or Monophobia
medical disorder (e.g., anxiety or worry about having stop hair pulling. Mysophobia
panic attacks in panic disorder, negative evaluation in Excoriation (skin-picking) disorder is characterized by Necrophobia
social anxiety disorder [social phobia], contamination or recurrent picking of one's skin resulting in skin lesions and Nyctophobia
other obsessions in obsessive-compulsive disorder, repeated attempts to decrease or stop skin picking. The Pharmacophobia
separation from attachment figures in separation anxiety body focused repetitive behaviors that characterize these Photophobia
disorder, reminders of traumatic events in posttraumatic two disorders are not triggered by obsessions or Thanatophobia
stress disorder, gaining weight in anorexia nervosa, preoccupations; however, they may be preceded or Toxophobia
physical complaints in somatic symptom disorder, accompanied by various emotional states, such as feelings Zoophobia
perceived appearance flaws in body dysmorphic disorder, of anxiety or boredom. They may also be preceded by an
having a serious illness in illness anxiety disorder, or the increasing sense of tension or may lead to gratification, 2. Social Phobia ( Social Anxiety Disorder)
content of delusional beliefs in schizophrenia or pleasure, or a sense of relief when the hair is pulled out or -> fear, anxiety or avoidance of social interactions
delusional disorder). the skin is picked. Individuals with these disorders may and situations where scrutiny is possible in addition to
have varying degrees of conscious awareness of the cognitive ideation of being negatively evaluated or
Other disorders related to OCD behavior while engaging in it, with some individuals offending others.
Body Dysmorphic Disorder displaying more focused attention on the behavior (with -> constant, irrational fear of specific or general
Characterized by preoccupation with one or more preceding tension and subsequent relief) and other situations that involve other people; fear of social
perceived defects or flaws in physical appearance that are individuals displaying more automatic behavior (with the performance and being judged by others.
not observable or appear only slight to others, and by behaviors seeming to occur without full awareness). -> Sufferer avoids social situations that could be
repetitive behaviors (e.g., mirror checking, excessive embarrassing, result in a negative evaluation, or show that
grooming, skin picking, or reassurance seeking) or mental PHOBIAS he/she is anxious.
acts (e.g., comparing one's appearance with that of other Characterized by disruptive and intense, irrational dread
people) in response to the appearance concerns. The of specific objects or situations. PANIC DISORDER
appearance preoccupations are not better explained by These fears are disproportionate to the actual danger of the Recurrent unexpected panic attacks and persistently
concerns with body fat or weight in an individual with an object or event. worried of having more panic attacks which may cause
eating disorder. Muscle dysmorphia is a form of body No one is wholly without fear. maladaptive behaviors.
 Characterized by intermittent anxiety and by a sudden
onslaught of symptoms called panic attacks.
People with panic disorder can fear losing control, going
crazy, or dying, and experience depersonalization and
derealization.
It can occur with or without agoraphobia
Types of Panic Disorder
A. Panic Attacks
-> episodes of intense fear and four or more
symptoms (e.g., heart palpitations, nausea, chest pain,
dizziness, sweating, trembling, choking sensations,
difficulty breathing, terror, intense apprehension).
-> Attacks tend to be brief but are recurrent and
unexpected.
-> May be expected reponse to typically feared
object or situation
-> Unexpected occurs for no apparent reason.
B. Depersonalization
-> state of feeling estranged from ones body
C. Derealization
-> State of feeling as if the world or surroundings are Bering easily startled or frightened
not real.
POST TRAUMATIC STRESS DISORDER (PTSD) Irritability or anger
a disorder that develops in some people who have
experienced a shocking, scary, or dangerous event such as: Overwhelming guilt or shame
War
Rape / Abuse
Calamities
Family losses
To be diagnosed with PTSD, an adult must have all of the
following for at least 1 month:
At least one re-experiencing symptom
At least one avoidance symptom
At least two arousal and reactivity symptoms
At least two cognition and mood symptoms
Re-Experiencing Symptoms:
Flashbacks reliving the traumatic event
Intense physical reactions to flashbacks
Nightmares
Severe distress when reminded of the trauma
Triggered by words, objects, or situations that
remind the person of the event
Disruptions in everyday routine
Avoidance Symptoms:
General memory problems
Hopelessness about future
Emotional numbing
Feeling detached from others
Avoiding certain places, events, or objects that remind a
person of the trauma
Challenges recalling important parts of the traumatic event
Trying to avoid thinking or talking about event
Avoiding activities once enjoyed
Trouble concentrating
Hyperarousal Symptoms:
Engaging in self-destructive behavior
Constantly tense or on-edge
Trouble sleeping
Hearing or seeing things that arent there
Differences from Acute Stress Disorder
Acute Stress Disorder is characterized by symptoms
similar to those of Posttraumatic Stress Disorder that
occur immediately in the aftermath of an extremely
traumatic event.
Must be diagnosed 1 month after the occurrence
Changes from DSM-IV-TR to DSM-5
No longer part of Anxiety Disorders
Moved to new type Trauma and Stressor-related
Disorders
Post-Traumatic Stress Disorder Subtypes
DISSOCIATIVE DISORDER
Dissociative disorders are characterized by an involuntary
escape from reality characterized by a disconnection
between thoughts, identity, consciousness and memory
by means of dissociation.
People from all age groups and racial, ethnic and
socioeconomic backgrounds can experience a
dissociative disorder.
Dissociation - a normal defence mechanism that helps us
cope during trauma. But it can become a dissociative
disorder if your environment is no longer traumatic but
you still act as if it is.
- You may get so used to using dissociation as a coping
strategy that you do not develop other strategies and you
start to use dissociation to deal with any kind of stress.
Symptoms
Significant memory loss of specific times, people and
events
Out-of-body experiences, such as feeling as though you
are watching a movie of yourself
Mental health problems such as depression, anxiety and
thoughts of suicide
A sense of detachment from your emotions, or emotional
numbness
A lack of a sense of self-identity
Three types of dissociative disorders
1. Dissociative Amnesia
- Significant memory loss of specific times, people and
events
2. Depersonalization / Derealization
- Out-of-body experiences, such as feeling as
though you are watching a movie of yourself
3. Dissociative Identity / Multiple Personality
- A lack of a sense of self-identity
- sapi
Causes:
abuse begins at an early age (the younger you are the
harder you will find it to cope with traumatic
experiences without dissociation)
 abuse is severe and repeated over a long period - or by
many people
abuse is painful and makes you scared
there is no adult who you have a good relationship with
and is able to provide comfort and help you process and
deal with the trauma
the abuse is done by someone you feel attached to
the abuser tells you that things didn't happen or that you
were dreaming
things are different at different times - for example things
seem normal during the day but at night you are abused
Somatic Symptom Disorder
(Somatoform Disorder)
- Characterized by multiple persistent physical complaints
that are associated with excessive and maladaptive
thoughts, feelings, and behaviors related to those
symptoms.
- A person feels extreme anxiety about physical symptoms
such as pain or fatigue.
Symptoms
Physical symptoms:
Pain
Neurologic problems
Gastrointestinal complaints
Sexual symptoms avoidance of activity, which can increase your level of
These reactions must persist for 6 months or more. disability
Feel extreme anxiety about symptoms
Feel concern that mild symptoms are a sign of serious
disease
Long-term problems may include:
Feel that the doctor does not take their symptoms
Social isolation and withdrawal
seriously enough or has not done a good job treating the
Loss of occupational or scholastic functioning
problem
Have trouble functioning because of thoughts, feelings, Decreased ability to have successful interpersonal
and behaviors about symptoms relationships
Separation or divorce
Causes Substance abuse and addiction
The exact cause of somatic symptom disorder isn't clear, Worsening physical health problems
but any of these factors may play a role: Cardiovascular disease
Genetic and biological factors, such as an increased Eating disorders
sensitivity to pain Chronic pain
Family influence, which may be genetic or environmental, Autoimmune diseases
or both
Depression
Personality trait of negativity, which can impact how you Self-harm
identify and perceive illness and bodily symptoms Suicidal thoughts and behaviors
Decreased awareness of or problems processing
emotions, causing physical symptoms to become the Treatment
focus rather than the emotional issues Trauma-focused cognitive behavioural therapy (CBT)
Learned behavior for example, the attention or other Talking Theraphy
benefits gained from having an illness; or "pain
behaviors" in response to symptoms, such as excessive